Causes and Prickly Heat Treatment Options

" There are a number of prickly heat treatment options available (also known as miliaria or heat rash). Since prickly heat involves the body's ability to regulate heat, the first approach is always to move the patient in a cooler environment with lower levels of humidity. In addition to moving the patient, there are a number of  home remedies and prescription treatment options to try."   

Causes of Prickly Heat Rash

To understand prickly heat treatment, you need to understand what causes prickly heat rash in the first place. It gives you a place to start when deciding what you want to do to take care of your rash.

The causes of prickly heat rash include the following:

  • Heat, humidity and perspiration
  • Plugged sweat ducts, or hair follicles, usually with staph bacteria found on everybody’s skin

When you are suffering from plugged hair follicles or sweat ducts, tiny, clear and water filled bumps form. If you burst those, they deliver a painful sting, because of the salt that’s in your sweat. Sweat also causes skin rashes, because it is an irritant.

Your rash may look like small bumps with pointed heads, clustered around the base of the hair follicles. It may be pale pink or red. If it gets worse, before it gets better, you may wind up with hives, welts, larger red bumps and an itch that won’t stop. Typically, prickly heat rash appears just about anywhere, including the face, neck groin, back, elbow folds, abdomen, buttocks and under breasts. Depending on where it is located, you may wish to try various prickly heat treatments.

prickly heat rash
Prickly Heat Rash Picture

The following podcast from the Centers for Disease Control provides an excellent overview of heat related diseases and conditions such as Prickly Heat and Heat Rash.

Types of Prickly Heat

To know what kind of prickly heat treatment to use, you need to know what layer of skin is affected. There are four categories of prickly heat rash, and those categories are:

  • Miliaria crystalline: no rash, just tiny blisters, may be minor symptoms
  • Miliaria rubra: most common, where sweat leaks into deeper layers of the skin. Itching, prickling sensation, no sweating in those areas. Heat exhaustion possible.
  • Miliaria profunda: severe form, causes severe burning sensation. Blockage is buried deep in sweat gland, leaking into the deep layers of skin. Risk of heat exhaustion very high.
  • Miliaria pustulosa: pustules from bacterial infection. Risk of heat exhaustion extremely high.

To know if you may be susceptible to prickly heat rash, it helps to know who it affects most often, such as:

  • Military troops
  • Obese/overweight people
  • Bedridden patients
  • Those with decreased sweating
  • Those with congenital absence of sweating
  • Athletes
  • People who workout in hot environments
  • Babies
  • Kids under the age of 4-years-old

Prickly Heat Diagnosis

Prickly heat rash does go away on its own. If it doesn’t, call the doctor, who will do a visual examination in combination with questions about heat exposure.

If you have serious heat rash problems, the doctor may take a skin culture, skin biopsy or examine skin scrapings under a microscope. They may also test for eczema, fungal infections, allergy reactions and bacterial infections.

Prickly Heat Treatment

There are many approaches that can bring relief during prickly heat treatment. The goal is to keep the skin dry and cool.  Powders and antiperspirants are the first line of defense in addition to staying out of the heat and humidity.  The heat rash itself can be treated with corticosteroid creams, although just moving to a cool air conditioned environment is often enough.

  Here's a list of common prickly heat treatment options:

  • Stay hydrated, drink lots of water.
  • Lower the ambient temperature in your surroundings.
  • Wash your rash several times a day. Only use soap for sensitive skin.
  • Indulge in cool baths or showers.
  • Place clean cotton cloth under skin folds to catch sweat.
  • Don’t wear synthetic clothing. Stick with cotton.
  • Use frozen peas or other vegetable packs or ice gel packs. Don’t leave them longer than 10 minutes or you may get ice burn. Repeat when necessary.
  • For moderate cases, hydrocortisone cream works well.
  • For moderate to severe prickly heat rash, the doctor may prescribe Triamcinolone acetonide, a synthetic corticosteroid.
  • For a bacterial infection, your may need antibiotics based on the type of infection you have.
  • Antihistamines (Claritin or Benadryl) for the itch.
  • Baby powder to help dry the skin.
  • Antiperspirants to dry the skin’s surface.
  • Calamine lotion.
  • Stri-Dex Acne medicated sensitive skin pads with salicylic acid.
  • Salicylic acid.
  • Menthol based creams.
  • Camphor based creams.
  • Topical creams with steroids.
  • Aloe vera gel.
  • Honey paste.
  • Lavender essential oil.
  • Chamomile.
  • Cool oatmeal baths.
  • Cool Epsom salts baths.
In addition to these prickly heat treatment remedies, it can be helpful to use a homeopathic product such as Skin Dr. which is known to support the skin healing process.

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Remedies for Prickly Heat Rash

Centers for Disease Control


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